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Health and care are in crisis – but next year's election campaigns will likely focus on local closures

Andrew Cozens
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How will the NHS and social care issues play out in the local elections for councils and mayors in May?

How can prospective leaders balance them with other complex issues such as ongoing cuts, devolution, business rates, or housing supply?

Last May’s local elections were overshadowed by the EU referendum. While the consequences of the vote to leave have profound implications for local government, candidates this May must have been hoping for a clearer run at local issues and challenges.

Those closest to the health and care system would expect it to feature as a headline issue. Non-specialists might have hoped that the social care challenge would have been addressed by the autumn announcement.

It had been anticipated that this winter would be a greater test to the system than previous ones. Warning signs were evident as emergency departments were running hot even before Christmas and the numbers of delayed discharges were proving stubbornly resistant all year to concerted efforts by councils and the NHS jointly.

The government’s initial response to these warnings was underwhelming. The autumn statement did not alter the NHS position. The subsequent local government settlement offered some relief to social care by redirecting funds and allowing councils to bring forward a further earmarked council tax rise. At best it is a hard sell on the doorsteps as to how a council tax rise will essentially only patch something up.

The publication of NHS sustainability and transformation plans added fuel to the flames. They were intended to position health economies for the future by looking hard at how services should change to promote effective care models. Their implementation requires a strong, shared direction of travel on where and how future needs can best be met.

It looks likely that opposition parties will maintain their focus on the NHS into this election cycle. Social care cuts will be swept up into this as either a contributory factor or a symptom of a wider malaise. On the ground it will be tempting for candidates to highlight local causes and to fight to save a service perceived to be under threat.

But after the dust has settled what does a viable path for social care look like for new cabinet members to tread?

The starting point has to be a shared vision to improve local people’s health and wellbeing, based on the twin pillars of prevention and a more integrated experience of assessment and services. A second key element is a strong sense of the needs of the place and common purpose for both commissioners and service providers in all sectors across the health and care system. The seas are rough but at least everyone will be in the same boat.

Andrew Cozens, independent social care and health specialist

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